Provider Demographics
NPI:1336314293
Name:ROGERS, LINDA PETERSON (PHD, RN, LMFT)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PETERSON
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHD, RN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N WASHINGTON ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3410
Mailing Address - Country:US
Mailing Address - Phone:703-241-4151
Mailing Address - Fax:703-533-9433
Practice Address - Street 1:405 N WASHINGTON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3410
Practice Address - Country:US
Practice Address - Phone:703-241-4151
Practice Address - Fax:703-533-9433
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000380106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist